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How a DRG is Built: A Payor’s Perspective

Presenter Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC
Broadcast Date 10/9/2024 Add this to your calendar!
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
How a DRG is Built: A Payor’s Perspective Webinar

Learn more about this event

The DRG system of inpatient hospital reimbursement in the U.S. will be discussed. The structure of DRGs will be outlined. The significance of ICD-10 CM and PCS codes with respect to DRG composition will be outlined.

Pertinent ICD-10-CM Official Guidelines for Coding and Reporting and PCS Guidelines will be highlighted. The implications of including or excluding codes will also be demonstrated.

Learning Objectives/Agenda

• The definition of a DRG
• To demonstrate why DRGs are important in the U.S.
• To illustrate how DRGs are constructed
• To define important considerations when composing a DRG
• To highlight certain ICD-10 CM and PCS guidelines that impact DRG composition.

Why is this topic important?

The DRG system is the main mechanism for short-term acute care hospital reimbursement in the U.S. Correct DRG composition ensures accurate reimbursement and population health data composition.

Who would benefit from this topic?

• Hospital Coders
• Hospital Coding Auditors
• Physician Advisors
• Fraud, Waste, and Abuse Auditors
• Hospital Appeal Writers
• Hospital Finance Associates

What is the presenter's background/expertise on this topic?

Internal Medicine Hospitalist involved in coding and documentation on both the payor and hospital-side for eight years. Recently, specialization in DRG Validation on the payor side.

Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC

About The Author

Amarin Alexander MD MBA MA, CPC-A, CDEI, CIC, CPMA, CRC

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